Eight randomised controlled trials (14 to 284 patients) were included in the review. One study scored 9 on the PEDro scale, two studies scored 8, one scored 7, two scored 6 and two scored 5. Follow-up ranged from one month to 12 months post-intervention. Reported losses to follow-up ranged from 14% to 86%.
Alcohol misuse in patients with mood disorders: One study found motivational interviewing and cognitive behavioural therapy over nine sessions were associated with larger significant reductions in alcohol consumption in patients with depressive disorders than was the case with brief interventions. In another study, improved alcohol use outcomes were found for patients with depression who received cognitive behavioural therapy compared to brief interventions but depression and global functioning outcomes were similar at 18 weeks follow-up.
Interpersonal psychotherapy of 16 weeks duration achieved significantly improved outcomes in depressive outcomes, compared to brief supportive psychotherapy but had little observed effect on alcohol consumption in patients with dysthymia. In one study motivational interviewing for a single 45-minute session was associated with significant reductions in alcohol use at six months compared to provision of an information package in hospitalised patients with mood and anxiety disorders. In one study, motivational interviewing was found to confer benefits in numbers of standard drinks consumed and fewer episodes of binge drinking compared to an attention-control group condition in a group of patients with mixed psychiatric inpatients; however, there were no differences between groups in patients who attended aftercare or in abstinence rates in this study.
Alcohol misuse in patients with anxiety disorders: In one study, cognitive behavioural therapy was found at three months follow-up to be associated with significant reductions in alcohol use and anxiety when treatment was focused either on alcohol use alone or on both alcohol use and anxiety. Another trial found significant effects on anxiety of cognitive behavioural therapy (12 weekly 60-minute sessions) and alcohol treatment compared to alcohol treatment alone in patients with social phobia. There were no differences between groups for alcohol use outcomes. A trial that compared 10 sessions of behaviour therapy with the same number of cognitive therapy sessions found that these interventions were similarly effective in reducing drinking and anxiety symptoms at 12 months follow-up; patients in this trial were diagnosed with panic disorder with agoraphobia and alcohol dependence.
Effect sizes for changes in alcohol use and depression/anxiety symptoms immediately following treatment: Interventions associated with large changes (at least one standard deviation) on alcohol use included therapist-delivered cognitive behavioural therapy for patients with depression (one study), group motivational interviewing for mixed psychiatric samples (one study), parallel cognitive behavioural therapy for alcohol and anxiety (one study) and targeted alcohol-focused cognitive behavioural therapy for patients with anxiety disorders (one study).